The Maternal-Fetal Medicine Division of the University of Alabama at Birmingham (UAB) submits this application to renew our participation as a clinical center of the Eunice Kennedy Shriver NICHD Maternal- Fetal Medicine Units (MFMU) Network. We present our center's current record of exceptional performance and specify new attributes and plans to increase our contributions to the Network's goals of investigating major problems in clinical obstetrics, particularly those related to low birth weight, prematurity, and medical complications of pregnancy. We have a well-established research infrastructure and extensive experience in performing relevant clinical trials both within and outside the MFMU Network. As a Network participating center over the last four 5-year cycles, UAB has played a leadership role in providing research direction for the Network at the Steering Committee and sub-committee levels, contributed efficiently to the conduct of Network trials, and participated significantly in the presentation and publication of data generated by these trials. Among 28 clinical centers in the history of the Network, a UAB investigator has first-authored approximately 25% of 180 current MFMU Network publications. Of 360 total Network presentations at national meetings, a UAB investigator presented 22%. Current members of the UAB investigative team have accumulated well over 150 person-years experience of active participation in or support of MFMU research projects. Alan Tita, MD, PhD and William Andrews, PhD, MD will continue as PI and Alternate. The team includes two previous site PI's and 5 members who have served as Network protocol chairpersons or Subcommittee members. Finally on the basis of patient recruitment, protocol adherence, retention and follow-up, data quality, and study start-up time, the MFMU Network Data Coordinating Center ranked us #1 or #2 among the participating centers 77% (10/13) of the time (#1 overall, 58% of the time). If successful in this competitive renewal application, we will marshal our facilities, equipment, data management systems (including our electronic perinatal record system), recruitment resources, strong investigative team and trained personnel even more to develop and implement MFMU Network protocols and projects. We believe that we remain well positioned for competitive renewal as an NICHD MFMU Network center for the next five years.